<div class="layuimini-container">
    <form id="app-form" class="layui-form layuimini-form">

        <div class="layui-form-item">
            <label class="layui-form-label">商家名称</label>
            <div class="layui-input-block">
                <input type="text" name="title" class="layui-input" lay-verify="required" placeholder="请输入商家名称" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">商家logo</label>
            <div class="layui-input-block layuimini-upload">
                <input name="logo" class="layui-input layui-col-xs6" lay-verify="required" placeholder="请上传图片" value="">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn" data-upload="logo" data-upload-number="one" data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image"><i class="fa fa-upload"></i> 上传</a></span>
                    <span><a class="layui-btn layui-btn-normal" id="select_logo" data-upload-select="logo" data-upload-number="one" data-upload-mimetype="image/*"><i class="fa fa-list"></i> 选择</a></span>
                </div>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label"></label>
            <div class="layui-input-block">
               <tip>建议等比例尺寸：200*100</tip>
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">联系人</label>
            <div class="layui-input-block">
                <input type="text" name="realname" lay-verify="required"  class="layui-input" placeholder="请输入联系人" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">联系电话</label>
            <div class="layui-input-block">
                <input type="text" name="mobile" lay-verify="required"  class="layui-input" placeholder="请输入联系电话" value="">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label required">绑定会员</label>
            <div class="layui-input-block" id="userdemo">
                <input type="hidden" id="openid" name="openid">
            </div>
        </div>
        <div class="layui-form-item">
            <label class="layui-form-label">商家资质</label>
            <div class="layui-input-block layuimini-upload">
                <input name="m_image" class="layui-input layui-col-xs6" lay-verify="required" placeholder="请上传图片" value="">
                <div class="layuimini-upload-btn">
                    <span><a class="layui-btn" data-upload="m_image" data-upload-number="one" data-upload-exts="png|jpg|ico|jpeg" data-upload-icon="image"><i class="fa fa-upload"></i> 上传</a></span>
                    <span><a class="layui-btn layui-btn-normal" id="select_m_image" data-upload-select="m_image" data-upload-number="one" data-upload-mimetype="image/*"><i class="fa fa-list"></i> 选择</a></span>
                </div>
            </div>
        </div>
        <div class="hr-line"></div>
        <div class="layui-form-item text-center">
            <button type="submit" class="layui-btn layui-btn-normal layui-btn-sm" lay-submit>确认</button>
            <button type="reset" class="layui-btn layui-btn-primary layui-btn-sm">重置</button>
        </div>
    </form>
</div>